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NPTE > UE testing > Flashcards

UE testing Flashcards

1
Q

sharp-purser test

A
  • pt neck flexed - causes symptoms
  • PT palm on forehead, thumb and forefinger on axis SP, posteriorly translate head
  • assesses transverse ligament - stabilizer of dens on atlas
  • (+) reduction in symptoms, click/clunk felt
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2
Q

alar ligament stress test

A
  • pt head in PT hand, other hand pincer grasp C2 SP
  • sidebend pt head to right and feel for left TP to come into fingers
  • (+) significant side bending with empty end feel, TP does not come into fingers
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3
Q

cervical radiculopathy

A
  • < 60 degrees rotation to involved side
  • (+) spurling’s - pressure through C spin
  • (+) distraction test
  • (+) median nerve
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4
Q

cervical flexion rotation test

A
  • pt flexes C spine to end range
  • PT stabilizes head and uses hands to rotate to end range
  • for upper C spine ROM - C1-C2
  • (+) is symptom reproduction or difference of 10 degrees in one direction
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5
Q

UE dermatomes and myotomes

A
  • dermatomes
  • C4: posterior lower neck, clavicle
  • C5: deltoid
  • C6: thumb
  • C7: middle finger
  • C8: pinky
  • T1: medial forearm
  • myotomes
  • C1/2: neck flexion
  • C3: neck side bending
  • C4: shoulder elevation
  • C5: shoulder abduction
  • C6: elbow flexion, wrist extension
  • C7: elbow extension, wrist flexion
  • C8: thumbs up (APB/EPL)
  • T1: finger abd.add
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6
Q

special tests for TOS

A
  • cervical rotation lateral flexion - 1st rib
  • ROOS (east) test
  • cyriax release test/passive scapular elevation
  • hyperabduction test
  • costoclavicular test
  • adson’s test
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7
Q

Roos test

A
  • pt abducts shoulders to 90, elbows flexed to 90, ER shoulders 90 - field goal arms
  • open and close fists through full range as quickly as possible for 3 (?) minutes
  • positive is increase in symptoms, sensation of heaviness or tingling
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8
Q

passive scapular elevation
cyriax release test

A
  • grab under pt forearms and support wrists
  • fully elevate pt shoulders and have them lean back 15 degrees
  • hold 1 minute
  • (+) reproduction of symptoms by unloading vascular bundle, causing numbness, tingling, cold, hot, fatigue
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9
Q

hyperabduction test

A
  • TOS
  • find pt radial pulse and passively abduct shoulder through complete range and ER arm
  • hold 1 minute
  • (+) is abolishment or decreased radial pulse or increase in symptoms
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10
Q

costoclavicular test

A
  • for TOS between clavicle and first rib
  • palpate radial pulse
  • pt retracts and depresses scapula as much as possible while arm into extension and slight abduction
  • hold 1 minute
  • (+) decrease in radial pulse or increase in symptoms
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11
Q

adson’s test

A
  • for TOS scalene entrapment
  • palpate radial pulse and passively abduct, extend, ER arm
  • pt takes deep breath and rotates head ipsilaterally
  • (+) abolishment or decreased radial pulse
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12
Q

brachial plexus test

A
  • TOS vs BP parasthesias
  • palpate upper trapezius and inferior portion of anterior scalene with thumb
  • squeeze 30 seconds and assess for symptoms
  • assess opposite side
  • (+) reproduction of parasthesias
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13
Q

shoulder arc of pain

A
  • usually 75-120 - can be flexion, abduction, or scaption/elevation
  • subacromial pain syndrome
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14
Q

neer test

A
  • subacromial pain syndrome
  • start with least aggressive version enecessary to reproduce pain
  • PASSIVE: block scapula, neutral rotation, full scaption
  • (+) if reproduces familiar pain
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15
Q

hawkins-kennedy

A
  • hawkins impingment test - subacromial pain syndrome
  • scaption/elevation position for subacromial impingement - bursa, supraspinatus
  • flexed and horizontally adducted for coracoid impingement - biceps against coracoid
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16
Q

empty can/full can

A
  • rotator cuff
  • suprapsinatus
  • 90 degrees elevation and full IR for empty can
  • 90 degrees elevation and neutral rotation for empty can
  • if EC is painful but full can is not, likely subacromial or bursa
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17
Q

champagne toast test

A
  • rotator cuff - supraspinatus
  • less deltoid and no impingement like EC/FC
  • 30-40 degrees of flexion and abd, slight ER, elbow 80-90 degrees flexion
  • PT attempt to push humerus back to neutral (Adduction and extension)
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18
Q

resisted ER at side

A
  • can be subacromial
  • at 45 degrees abduction - infraspinatus
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19
Q

speed’s test

A
  • biceps tendinopathy
  • pt shoulder felxed to 90, palm up (ER), slight bend in elbow
  • resistance to distal forearm while palpating biceps tendon - reproduction of symptoms at biceps tendon
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20
Q

yergason’s test

A
  • LHB pain
  • elbow by side, flexed to 90
  • pt supinates arm against PT resistance
  • (+) reproduction of symptoms
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21
Q

drop arm

A
  • supraspinatus
  • test: straight arm in abduction
  • sign: bent elbow in scaption
  • pt arm passively to 90 degrees
  • (+) unable to hold position or slowly lowers involved arm with control
  • straight down - supraspinatus
  • hand in/horn blower - infraspinatus
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22
Q

external rotation lag sign

A
  • infraspinatus, teres minor
  • passively flex pt elbow to 90, abduct shoulder 20 degrees, max ER
  • pt asked to maintain position
  • (+) if fall into IR
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23
Q

belly press test

A
  • subscapularis
  • pt involved hand on belly, tries to push palm into belly
  • (+) if pt flexes at wrist, uses shoulder ext/add to push into belly
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24
Q

internal lag sign

A
  • subscapularis - also need good shoulder IR
  • pt hand behind back like functional IR
  • pt asked to lift/hold arm off back
  • (+) pt unable to maintain arm off back
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25
Q

load and shift

A
  • MDI
  • stabilize clavicle and scapula
  • gently load humerus - push into glenoid
  • glide humeral head ant and post
  • note amount of translation and end feel
  • (+) is movement (not pain)
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26
Q

sulcus sign

A
  • MDI
  • stabilize scapula by holding acromion
  • pull downward on distal humerus to produce inferior traction force on GH joint
  • (+) is depression between acromion and humeral head
  • 1+ is < 1 cm
  • 2+ is 1-2 cm
  • 3+ is > 2 cm
27
Q

hyperabduction

A
  • MDI
  • stabilize scapula, pt arm passively abducted - elbow flexed to 90, forearm parallel to floor
  • > 110 degrees is lengthening/laxity of IGHL and positive in 85% with instability
28
Q

load and shift in supine

A
  • for return to sport with labral tear or repair
  • pt supine, arm 90/90
  • grasp proimal humerus with inside hand and distal humerus with outside hand
  • stabilize distal humerus and shift proximal ant/post in plane of scapula/glenoid
  • the crazy david james one
29
Q

apprehension test

A
  • anterior GH, bankart lesion
  • pt supine, arm 90/90
  • shoulder progressively ER - passively
  • (+) pt reports pain or apprehension
  • relocation - same test but posterior pressure applied at proximal humerus
30
Q

jerk test

A
  • posterior, 7-11 tears
  • axial force applied to arm in 90 degrees abduction and IR
  • pt arm horizontally adducted (scaption to midline) - maintain axial load
  • (+) sharp pain with click/clunk
  • can also be infraspinatus if other infrapsinatus involvement
31
Q

kim test

A
  • posterior, 6-9
  • axial force applied to arm in 90 degrees abduction
  • arm elevated 45 degrees diagonally upward with backward force applied at proximal humerus
  • (+) posterior shoulder pain with click
32
Q

o’briens

A
  • activate compression test
  • SLAP tear
  • pt shoulder flex to 90, elbows extended
  • first full IR, adduction - backs of hands together and resist downward force on arms
  • then full supination - resist downward force again
  • deep pain - biceps labral complex
  • over AC joint - AC joint pathology
  • posterior shoulder pain - SLAP
  • anterior shoulder pain - LHB
  • (+) if pain eleicited with first and eliminated with second
  • if both painful, subacromial
33
Q

modified dynamic sheer test

A
  • SLAP
  • pt seated
  • pt shoulder put into 120 abd and max ER w/ elbow at 90
  • palpate post joint line and lower 120 -> 60
  • max ER, 30-60 abd, axial load
  • (+) painful click
34
Q

biceps load II

A
  • SLAP
  • abduct pt (supine or seated) shoulder to 120, flex elbow to 90
  • resist patient elbow flexion
  • (+) deep shoulder pain
35
Q

resisted supination with ER

A
  • SLAP
  • pt supine
  • passively abduct arm to 90 degrees
  • pt tries to supinate against resisted force - fires biceps
  • passively ER shoulder
  • (+) reproduction of symptoms, clicking, popping
36
Q

LHB intra-articular tendon pathology

A
  • throwers/overhead sports
  • presents like SLAP
  • active compression/o’briens
  • thrower’s test
  • palpation within proximal groove
37
Q

crossbody adduction test

A
  • pt shoulder passively flexed to 90 and adducted across pt body
  • (+) pn at AC joint
38
Q

resisted extension/horizontal abduction

A
  • pt horizontally abducts arm against resistance
  • (+) pn in AC joint
39
Q

cozen’s test

A
  • for lateratal epicondylalgia
  • pt elbow in full extension
  • PT thumb over lateral epicondyle
  • wrist into extension with hand in fist
  • slight pronation with radial deviation
  • try to move pt out of position
  • (+) reproduction of symptoms
40
Q

mill’s test

A
  • lateral epicondylalgia
  • shoulder in 70 degrees abd, 90 degrees flexion
  • thumb inside fist
  • flex and ulnarly deviate hand
  • extend elbow slowly
41
Q

third finger test

A
  • lateral epicondylalgia
  • PT resists extension of middle finger
42
Q

elbow flexion test

A
  • cubital tunnel syndrome
  • pt fully flexes elbow with neutral wrist
  • maintain position 1-3 minutes or until reproduction of symptoms
43
Q

shoulder IR test

A
  • cubital tunnel syndrome
  • pt UES 90/90, max IR
  • (+) if any symptoms within 10 seconds
44
Q

froment’s sign

A
  • cubital tunnel syndrome
  • patients grips piece of paper using lateral key grip, PT tugs paper
  • normal: pt maintains lateral key grip - adductor pollicis in tact
  • (+) change of thumb and forrefinger to “O” - indicates use of flexor pollicis longus
45
Q

wartenburg’s sign

A
  • cubital tunnel syndrome
  • examiner passively spreads pt fingers apart on table
  • patient adducts fingers
  • (+) inability to adduct pinky finger
46
Q

tinnel’s sign

A
  • cubital tunnel syndrome
  • pt supine, field goal arms
  • tap ipsilateral cubital tunnel
  • (+) reproduction of familiar symptoms
47
Q

PTS test

A
  • median nerve - pronator teres syndome
  • pt seated
  • flex elbow to 90 and passively pronate forearm at wrist
  • apply resistance into supination to activate pronator muscle
  • pt resists as PT extends elbow
48
Q

pinch grip
ok sign

A
  • median nerve - anterior interosseous syndrome
  • pt asked to pinch tips of index finger and thumb together to make “Ok” sign
  • (+) not tip-to-tip but pad-to-pad, indicates anterior interosseous nerve (branch of median nerve) pathology or compromised AIN
49
Q

elbow valgus stress test

A
  • at 0 and 30 degrees of flexion
  • apply valgus force
  • for UCL
50
Q

moving valgus stress test

elbow

A
  • pt seated w/ shoulder 90 degrees abd
  • passively apply valgus from extension to flexion
51
Q

varus stress test

elbow

A
  • at 0 and 30 degrees
  • for radial collateral ligament injury
52
Q

pivot shift apprehension test

elbow

A
  • posterolateral instability
  • pt supine with arm overhead and palm supinated
  • PT standing at head of table - apply axial load, flex elbow, apply valgus stress
  • (+) radius/ulna sublux off humerus, sudden clunk of joint at 40-70 degrees flexion
53
Q

biceps squeeze test

A
  • bicep rupture
  • pt seated w/ arm in lap, elbow flexed 60-80 degrees, slight pronation
  • squeeze bicep with both hands
  • (+) lack of supination - indicates rupture of biceps brachii tendon
54
Q

biceps hook test

A
  • biceps rupture
  • pt seated, elbow at 90
  • insert tip of index finger under medial or lateral edge of biceps tendon in antecubital fossa
55
Q

motions of the thumb

A
56
Q

thumb ulnar collateral ligament stress test

A
  • for tear of UCL
  • seated, arm on table, thumb up
  • take pt thumb to full extension
  • apply valgus stress to UCL
  • (+) more than 30-35 degrees movement
57
Q

first CMC grind test

A
  • for OA
  • seated, arm on table, thumb up
  • follow MC down to CMC joint line and grind joint
  • (+) reproduction of symptoms
58
Q

watson’s scaphoid shift

A
  • scapholunate instability
  • seated arm on table
  • place pt hand in extension and ulnar deviation
  • palpate scaphoid
  • passively move hand into radial deviation and release scaphoid
  • (+) palpable/audible clunk or pain
59
Q

carpal bones

A
  • scaphoid, lunate, triquetrum, pisiform
  • trapezium, trapezoid, capitate, hamate
  • “um odd”
60
Q

finklestein test (eichoff’s)

A
  • dequervain’s tenosynovitis
  • seated, hands in fist w/ thumb inside fingers
  • stabilize forearm and deviate wrist in ulnar direction
  • (+) reproduction of pain of APL and EPB
61
Q

WHAT test

A
  • dequervain’s tenosynovitis
  • seated, arm on table, wrist flexed, fingers to floor
  • stabilize hand
  • pt thumb into radial adduction against PT pressure - resist adductuction
  • (+) reproduction of pain

APL and EPB

62
Q

tinel’s

carpal tunnel syndrome

A
  • CTS - median nerve
  • pt seated, arm on table, palm up
  • support pt hand in neutral wrist
  • tap carpal tunnel up to 30 seconds
  • (+) reproduction of symptoms
63
Q

phalen’s

A
  • CTS - median nerve
  • pt seated
  • ask pt to fully flex both wrists, backs of hands together for up to 60s
  • (+) reproduction of numbness or paresthesias in median nerve distribution
64
Q

carpal compression test

A
  • CTS - median nerve
  • pt seated, arm on table, palm up
  • apply even, constant pressure over CT to compress median nerve
  • hold up to 30s
  • (+) reproduction of median nerve symptoms

NPTE (32 decks)

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